[The internal medicine patient at the general hospital]. 1984

F Besançon, and H Ricome-Pequignot

Patients are defined as internal medicine patients when more than one system is involved. Such patients are lacking in the clinical and epidemiological literature. Among 330 patients discharged from a unit of internal medicine, 212 (64%) were prospectively classified in that category. As compared to the "specialty patients", the "internal medicine patients" were almost the same age (56 vs 53 years) and sex, but more diagnoses were recorded for each: 4.16 vs 2.9 p less than 0.001; their death rate was apparently higher: 12.7% vs 7.6% (NS). Therapeutic results were poor. Psychic disturbances were prevailing, with classical mental diseases, but also major somatic consequences of seemingly minor behavioral deviations. This morbidity is largely avoidable. The discussion addresses the validity of results and their confrontation with data collated in the literature; a few specific characteristics of care; the widely variable psychological reactions of nurses, students, residents and physicians; risks of rejection from the general hospital, for technical and economic reasons; and lastly, risks of rejection by public opinion. Who is prepared to be involved with major morbidity which is time-consuming, largely refractory to management, preventable, unchallenging for some though instructive for others, unsaleable and useless as a vote-catcher?

UI MeSH Term Description Entries
D007388 Internal Medicine A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009017 Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Morbidities
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006769 Hospitals, General Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients. General Hospital,General Hospitals,Hospital, General
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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